Why Can Some Patients Get Free Drugs While Others Can't?

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"We are committed to helping patients, and that commitment is evident in the $140 million of financial assistance we provided in 2008," spokesperson Shannon Altimari said in an e-mail. That accounts for 5% of the $2.79 billion in revenue that the company made from the two drugs in 2008.

Pfizer (PFE) announced a program in May called Maintain that provides free medication to unemployed patients who lack prescription drug coverage. Maintain is one of several patient assistance programs that the company offers.

Chicago-based Abbott Laboratories, which makes Miller's Humira, has provided that medication to patients in need since it came onto the market. The company introduced a Humira Protection Plan in March that helps reduce co-pays for insured patients to $5 per month. "The plan was really a response to patient and physician feedback that they needed more support," says Abbott spokesperson Elizabeth Hoff. The company earnings release says it gave out $255 million of free medicine last year and made $29.5 billion in sales. Total U.S. sales for Humira in 2008 were $2.25 million, but the company does not break out how much was given away.

Some people say that these offerings avoid the real problem. Larry McNeely, a health-care analyst at Washington (D.C.)-based U.S. Public Interest Research Groups (PIRG), says: "They're a Band-Aid on the gaping wound of unaffordable prescription drugs." He says that the high cost of medicine is a systemic problem that can only be fully addressed with legislation. "This is not a struggling industry. This is not automobiles," he says. "They're raking in profits."

Hit-Or-Miss for Patients

McNeely does not like the fact that PAPs are so hit-or-miss for patients. He worries that people have "tried to go through these programs and gotten lost in the shuffle." He advises patients to read the fine print and be careful not to get stuck without medication while waiting for approval.

Cynda Moss has experienced such problems. The 56-year-old retired teacher was diagnosed with Parkinson's disease in 1999, followed by lung cancer in 2001. Her income from social security and teacher retirement barely stretches far enough to cover her mortgage, medical bills, and other living expenses. "I have tried all sorts of avenues to see if I can get assistance with the drugs," she says. She called representatives for her pharmaceutical companies, Social Security, and Medicare. She has also followed several leads on the Internet. But because she has insurance, "they immediately tell me I'm disqualified," she says.

Moss' prescriptions can cost as much as $20 per pill, and her medical expenses are more than $500 per month. "There are times when I have had to forgo a pill or two here or there," she admits. Moss is not sure what the future holds for her.

While McNeely at PIRG believes that there needs to be a change in the system, he says: "If folks need assistance, don't give up. There are some potential options out there." Miller is one of the success stories. She says that because of her arthritis medication, "I have a chance at becoming a little bit more normal."

Click here to see what you need to do to find a patient assistance program that is right for you.

Holden is an intern in BusinessWeek's Atlanta bureau.

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